This PDF is the current document as it appeared on Public Inspection on 06/25/2014 at 08:45 am.
Veterans Benefits Administration, Department of Veterans Affairs.
In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration (VBA), Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument.
Comments must be submitted on or before July 28, 2014.
Submit written comments on the collection of information through www.Regulations.gov, or to Office of Information and Regulatory Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 17th St. NW., Washington, DC 20503 or sent through electronic mail to email@example.com. Please refer to “OMB Control No. 2900—NEW (Statement in Support of Claim for Disability and Related Compensation Benefits Due to Exposure)” in any correspondence.Start Further Info
FOR FURTHER INFORMATION CONTACT:
Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7492 or email firstname.lastname@example.org. Please refer to “OMB Control No. 2900—NEW (Statement in Support of Claim for Disability and Related Compensation Benefits Due to Exposure).”End Further Info End Preamble Start Supplemental Information
Title: Statement in Support of Claim for Disability and Related Compensation Benefits Due to Exposure Due to Exposure (VA Form 21-0964).
OMB Control Number: 2900—NEW.
Type of Review: New collection.
Abstract: VA will use the information collected on VA Form 21-0964 to gather information related to exposure. The form will be used to determine if a veteran has been exposed for the purposes of benefits.
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published on April 16, 2014, at pages 21518-21519.
Affected Public: Individuals and Households.
Estimated Annual Burden: 20,000 hours.
Estimated Average Burden per Respondent: 20 minutes.
Frequency of Response: One time.
Estimated Number of Respondents: 6,667.Start Signature
Dated: June 23, 2014.
By direction of the Secretary.
Department Clearance Officer, Department of Veterans Affairs.
[FR Doc. 2014-14949 Filed 6-25-14; 8:45 am]
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